Où Est l’Hôpital?

Kathy Wilhelm

I’D JUST ARRIVED IN the charming, car-free village of Murren in the Swiss Alps, and was trying to find my B&B on the helpful signpost near the station. Stepping back for a better view, I tripped over the curb, with my backpack pulling me further off-balance. I went down with my left wrist under my hip.

Two wonderful British couples rushed to my assistance. One pair took my backpack to my B&B and the other escorted me back down the mountain to a doctor’s office. The doctor sent me to the nearest hospital in a taxi, where I was greeted with a request for my insurance card. Since I still sound English, I’m sure the staff expected to see a European Health Insurance Card, or EHIC, which would guarantee that my home country’s health insurance system would pay the bill. Instead, they got the membership card for my ex-employer’s retiree group coverage.

I had broken my wrist badly enough that I needed surgery to insert pins to hold the bones together, after which I spent a night in traction in a six-person ward. Clearly, I wasn’t going to spend the next six weeks traveling solo across Europe. Instead, I’d be going home. Good thing my medical insurance would reimburse me for the hospital bills.

Planning a trip abroad? There are three kinds of insurance to consider.

Cancellation-and-interruption coverage. I rarely buy this. My ramble across Europe was meant to end with a Rick Steves tour of Greece. Fortunately, at the time, the cost of the tour included cancellation coverage, but the terms and conditions have since changed. The company refunded the cost of the tour, except for the deposit, which I was allowed to apply to the same tour the following year. Aside from flights, I was able to cancel my other arrangements without penalty, so I was only out a few hundred dollars.

You can choose to self-insure instead of buying this kind of insurance, which is what I usually do. Still, if your health—or that of a loved one—is precarious, you might want coverage. Keep in mind that most policies require you to make the insurance purchase within a few days of booking the trip if you want pre-existing conditions covered.

Also be sure to read the policy carefully. People have been surprised to discover that pandemics, insurrections, terrorism and wars, among other things, aren’t usually covered. These days, you also need to check the COVID-19 and quarantine provisions. Want a policy that allows “cancel for any reason”? They do exist, but they’re expensive and you still don’t get a 100% refund.

Cancellation-and-interruption policies usually include add-ons like baggage insurance (though lost baggage may also be covered by your homeowner’s or renter’s policy) and coverage for hotel costs if your flight is canceled. Meanwhile, coverage for cancelling a rental car may come with one of your credit cards. Make sure you check your credit card’s provisions for the countries you’re visiting.

I’d consider cancellation insurance if I were taking an expensive tour or cruise, regardless of age or health status. Try comparing policies at InsureMyTrip and SquareMouth. Buying it from the company providing the tour or cruise can be an expensive mistake. Just ask the folks who were planning a trip with Vantage Travel.

Medical insurance. I don’t care how young and healthy you are, accidents happen, as I can attest. If you’re under 65, your U.S. medical insurance may offer coverage abroad. If you’re on Medicare, you’ll only have coverage if you have Medigap plan C, D, F, G, M or N, or a Medicare Advantage plan or an employer-provided retiree plan that includes overseas medical insurance.

Whatever coverage you have, give it a close read. Medigap coverage typically has a lifetime max of $50,000 and a 20% co-pay. As you get older, meaning over age 70 or 75, you may have difficulty getting travel medical insurance, plus it’ll cost more. What if you’re under 70? I’d recommend saving any Medigap insurance for later, and taking out overseas medical insurance while it’s cheaper. Make sure it’s designated as your primary coverage.

Although I’ve seen doctors in the U.K., France and Italy for colds and the flu, an ophthalmologist in Georgia for floaters, and dentists in Poland and China, the visits have either been free or cheap enough that I didn’t bother filing a claim. That’s not what this insurance is for.

Evacuation-and-repatriation coverage. This is what I needed to get back to the U.S. from Switzerland. You have to be careful about terminology. Medical evacuation will get you to the nearest “suitable” facility. Sometimes, it will also get you home—but sometimes it won’t. Meanwhile, sometimes the repatriation coverage will get you home, but sometimes it’ll only get your dead body home. The policy I buy calls the latter “return of mortal remains” and covers it separately.

You may think all this is unnecessary. While I appreciated that my coverage paid for a driver to take me to Geneva airport and for the flights back to the U.S., I could have got myself home, even with a broken wrist. But if I had broken my hip—as happened to a friend in Portugal—or had a heart attack and needed a nurse in attendance, it would have been extremely expensive and more difficult to arrange.

My advice: Don’t skimp on this coverage. It’s one thing to self-insure for cancellation and interruption. It’s quite another to self-insure for medical evacuation. I buy evacuation coverage in combination with medical insurance. Ever since the firm got me home from Switzerland, I’ve bought coverage from Seven Corners, although I haven’t checked its policies lately. If you only need evacuation insurance or you’re on an extended trip, take a look at MedJet Assist.

Some trip cancellation-and-interruption policies also include medical and evacuation coverage, so you can buy all three types of insurance together. I think that cancellation-and-interruption insurance is only necessary in limited circumstances, but I consider medical, evacuation and repatriation coverage nonnegotiable.

Bottom line: Decide what you really need to cover and then read all of the fine print. More than once.

Kathy Wilhelm, who comments on HumbleDollar as mytimetotravel, is a former software engineer. She took early retirement so she could travel extensively. Some of Kathy’s trips are chronicled on her blog. Born and educated in England, she has lived in North Carolina since 1975. Check out Kathy’s previous articles.

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